PatientIQ Patient Portal

Complete Tasks Below
Click on the items below to complete.

Complete Tasks Below
Click on the items below to complete.

Answer the below questions about your physical ability

	Without any difficulty	With a little difficulty	With some difficulty	With much difficulty	Unable to do
Are you able to do chores such as vacuuming or yard work?
Are you able to go up and down stairs at a normal pace?
Are you able to go for a walk of at least 15 minutes?
Are you able to run errands and shop?

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Answer the below questions about your health

	Not at all	Very little	Somewhat	Quite a lot	Cannot do
Does your health now limit you in doing two hours of physical labor?
Does your health now limit you in doing moderate work around the house like vacuuming, sweeping oors or carrying in groceries?

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